Individual provider · NPI-1

Vipasha Desai

Dentist · New London, CT

NPI number1891059465
StatusActive
Last updated in NPPESMay 20, 2013

Details

NPI
1891059465
Entity type
Individual (NPI-1)
Name
Vipasha Desai
Sex
Female
Sole proprietor
No
Enumeration date
Jun 28, 2012
Last updated
May 20, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist010778CTYes
1223G0001X Dentist, General Practice010778CT

Practice location

258 S Frontage Rd
New London, CT 06320-2641

Phone 860-347-3485

Mailing address

33 Horizon Hill Rd
Newington, CT 06111-5115

Phone 860-371-5885

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Dentist providers in New London, CT